Interview 1: From Clomid to Adoption
We begin our monthly interview series with Sue, whose blog “In a Holding Pattern” charts four years of infertility treatments and the progression to adoption. At the time of writing, Sue and her husband are awaiting the arrival of a baby from Korea.
Here’s Sue’s story:
“After 6 months of unsuccessfully trying to conceive, I starting BBT charting and during the first month discovered I wasn’t ovulating due to hypothyroidism. I also had a diminished ovarian reserve; my FSH blood test was 14.9 at age 31 – very high for someone my age – and my ovaries were very small, indicating I did not have many eggs. Furthermore, my uterus was abnormally shaped and my uterine lining was poor – these were probably the result of my being exposed to DES while my mother was pregnant with me. To top it all off, I had mild endometriosis.
Shortly after my thyroid imbalance was corrected with medication, I conceived but unfortunately it was an ectopic pregnancy. I was unaware of the pregnancy until it was 8 weeks along because I continued to have periods. In week 8, the ectopic ruptured and I landed in the ER. I had emergency surgery to stop the bleeding, and my doctor was able to remove the pregnancy without removing my tube.
Several months later we were given the go-ahead to start trying again. After 6 more months of unsuccessful au natural trying, we started Clomid cycles. After 3 unsuccessful Clomid cycles via intercourse, we did 3 IUIs with Clomid – all unsuccessful.
We then started going to an IVF clinic – by then, I was 33. Because my FSH was high, my doctor put me on a very aggressive course of fertility drugs, prescribing the maximum dosage. Despite this, my cycle was very disappointing. I only produced one follicle, when they typically aim for 15-20. I was termed a “poor responder” and my IVF cycle was converted to an IUI cycle, which of course failed.
The next month we tried again with a different protocol. This time was better, and 8 eggs were retrieved. 3 ultimately fertilized, and one was transferred. (We only transferred one because my doctor believed my mis-shapen uterus could not handle a twin pregnancy). After 2 weeks, my Beta HCG was 5 – a negative result (or so my doctor told me).
A full month later, my period was late, and a home pregnancy test turned up positive! I thought that my husband and I had gotten pregnant the natural way just 2 weeks earlier. Alas, that was not the case. A Beta HCG was 4,000 – much too high for a 4 week pregnancy, but much too low for an 8 week one. An ultrasound confirmed there was nothing in my uterus. The doctors concluded that I had a second ectopic pregnancy which had resulted from the supposedly-failed IVF cycle. Needless to say, I was crushed.
We tried to end this ectopic pregnancy medically via a shot of Methotrexate. It did not work, and 8 days later it ruptured and I was bleeding out internally. Within an hour, I had lost about half of my blood, went into shock, and required a large blood transfusion. Thank goodness I was able to call an ambulance before I passed out. This time, the ectopic pregnancy was in the opposite tube of my first ectopic. They removed the tube, leaving me with just one.
At that point, I had experienced two ectopic pregnancies, one in each tube. My doctors told me my chances of a third pregnancy being ectopic was >50% if I kept my remaining tube. I therefore chose to have the tube surgically removed, because it would nearly completely eliminate my chances of another ectopic but I could still pursue pregnancy via IVF.
After recovering from surgery, we attempted IVF #3. It failed with only one egg retrieved which failed to fertilize. We then attempted an FET of my two frozen embryos from IVF #2, but the embryos did not survive the thaw. IVF #4 also failed – again I produced just one egg on the maximum dosage of medication.
After that, we gave up. My body did not respond to the fertility drugs and it seemed like IVF was a giant waste of money considering my body produced one egg a month on its own without all the expense and turmoil. Since I no longer had any tubes, I was unable to get pregnant at all without IVF. We considered donor egg or donor embryos, but my doctor said that with my history of DES exposure, poor uterine lining, and abnormally shaped uterus, the chances of a donor egg or embryo implanting and then being successfully carried to term were not that great. The risk of miscarriage or pre-mature birth would be 4 times that of a normal woman my age. Considering that in our area donor egg costs $40K per cycle, the state of our finances after 4 IVF attempts, the risks of miscarriage, the risk of prematurity and its resultant conditions, and my husband’s worries that pregnancy would yet again endanger my life, we decided we could not go that route.
So, after 4 years of trying to start our family, we went for adoption. We considered domestic adoption, but after years on the infertility treadmill with one crushing disappointment after another, I did not feel strong enough emotionally to deal with the uncertain timelines of the US process. I resisted international adoption at first because I really wanted a newborn baby, but after reading some blogs on adoption I learned some people were adopting babies from Korea that were only 4 months old and that the process was taking only a year.
It was a real light at the end of the tunnel for me. I realized that all this could be over – that I could mom of a baby within a year. My husband had been encouraging me to consider adoption for some time, so once I made up my mind to go for it we started the application process.
Of course, now that we are in process, the rules for Korean adoption have changed. The length of the process is now about 18 months from start to finish, and by the time our baby comes home with us he/she will probably be 9-12 months old.”
What is the one area where you wished you’d had more support?
“My family was not very helpful. They kept telling me to relax! But relaxing cannot grow back one’s missing tubes or increase the number of eggs I had left! It just made me feel, yet again, that not conceiving was somehow my fault, that I was either not trying hard enough or trying too hard. All of which was nonsense. Nothing will make my tubes grow back, but I still felt the guilt.”
What advice would you give others who are having problems conceiving?
“Remember that it is OK to give up fertility treatments and pursue other options. The fact that you are willing to give up medical treatments does not mean that you are not tough enough or worthy enough to have a child. Even after 2 emergency surgeries, 4 IUIs and 4 IVFs I still felt that I had to keep pursuing medical treatment. A friend had to basically slap me across the face with the idea that it was okay to quit, and that doing so wasn’t an indictment of my parental fitness.
Unfortunately, infertility is so emotionally devastating and so damn unfair that it can really mess with your mind and sense of rationality. You start to think of your body as a Bermuda triangle of sorts – a zone where all odds are defied and logic, science, desire, faith, whatever…. no longer make any difference and in fact just conspire against you. Even though I am very scientific by nature, I found myself becoming very superstitious and convinced that the Universe was somehow out to punish me for something.
It’s only now that I’ve stepped out of that abyss and am on a more positive, productive path toward adoption that I can really see how screwed up and irrational my thinking was during that difficult time.
Now that we are on the road to adoption, I cannot even imagine going back to the infertility treatment madness. International adoption is such a positive road compared to infertility treatment. Sure, there are delays and the wait is long, but you are not on a rollercoaster every month where you hope, hope, hope and then you are left devastated.
And remember, infertility is hard on your husband as well. In fact, it might be harder because there are fewer support resources for him. I went to support groups at my IVF clinic and found the infertile blogging community – all of which are 98% female. There is very little out there for men.
Also, be a proactive researcher of your own medical conditions. Learn to use Medline to look for journal articles on your specific conditions and the latest research. Ask lots of questions of your doctors.”
To follow Sue’s adoption and to read more about her story, visit her blog at http://holdingpattern.typepad.com/ .
© Fiona Young-Brown, 2006.
"You don't have to see the whole staircase, just the first step."
- Martin Luther King Jr.
E-mail: Fiona@fionayoungbrown.com